• Title/Summary/Keyword: Diagnostic assessment

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Diagnostic accuracy of clinical tests to rule out elbow fracture: a systematic review

  • Giorgio Breda;Gianluca De Marco;Pierfranco Cesaraccio;Paolo Pillastrini
    • Clinics in Shoulder and Elbow
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    • v.26 no.2
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    • pp.182-190
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    • 2023
  • Elbow traumas represent a relatively common condition in clinical practice. However, there is a lack of evidence regarding the most accurate tests for screening these potentially serious conditions and excluding elbow fractures. The purpose of this investigation was to analyze the literature concerning the diagnostic accuracy of clinical tests for the detection or exclusion of suspected elbow fractures. A systematic review was performed using the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) guidelines. Literature databases including PubMed, Cumulative Index to Nursing and Allied Health Literature, Diagnostic Test Accuracy, Cochrane Library, the Web of Science, and ScienceDirect were searched for diagnostic accuracy studies of subjects with suspected traumatic elbow fracture investigating clinical tests compared to imaging reference tests. The risk of bias in each study was assessed independently by two reviewers using the Quality Assessment of Diagnostic Accuracy Studies 2 checklist. Twelve studies (4,485 patients) were included. Three different types of index tests were extracted. In adults, these tests were very sensitive, with values up to 98.6% (95% confidence interval [CI], 95.0%-99.8%). The specificity was very variable, ranging from 24.0% (95% CI, 19.0%-30.0%) to 69.4% (95% CI, 57.3%-79.5%). The applicability of these tests was very high, while overall studies showed a medium risk of bias. Elbow full range of motion test, elbow extension test, and elbow extension and point tenderness test appear to be useful in the presence of a negative test to exclude fracture in a majority of cases. The specificity of all tests, however, does not allow us to draw useful conclusions because there was a great variability of results obtained.

Utility of PET in follow-up of patients with colorectal cancer (대장 직장암 환자의 수술 후 추적 관찰에서 PET의 유용성)

  • Ryu, Young-Hoon;Yun, Mi-Jin;Lee, Jong-Doo
    • 대한핵의학회:학술대회논문집
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    • 2002.05a
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    • pp.17-24
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    • 2002
  • Recurrence of colorectal cancer after apparently curative resection remains common, with reported relapse rates of up to 40%. Because complete resection of solitary metastases or local recurrence may improve long-term survival, surgical management of such cases has become increasingly aggressive but has led to only modest survival benefit. The limitations of current approaches based on structural imaging are well documented, with over half of the patients who are thought suitable for curative surgery being found to have unresectable disease at operation. Therefore, better preoperative assessment is crucial. The increasing use of FDG-PET as an oncologic staging investigation has significantly improved the assessment of patients with suspected colorectal cancer recurrence. Several studios show that substantial and largely appropriate changes in patient management occur, often soaring patients the significant morbidity and mortality associated with aggressive but futile therapies while also saving scarce community resources. Nevertheless, the clinical relevance of these findings has still been questioned. The utility of PET in routine clinical practice will likely depend on its ability to provide incremental information compared with CT in selected patients rather than to serve as a replacement for CT. In conclusion, in patients with suspected recurrent or metastatic colorectal carcinoma, FDG-PET should be performed (1) when there is rising carcinoembryonic antigen levels in the absence of a known source, (2) to increase the specificity of structural imaging when there is an equivocal lesion, and (3) as a screening method for the entire body in the preoperative staging before curative resection of recurrent disease.

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Organ Dose Assessment of Nuclear Medicine Practitioners Using L-Block Shielding Device for Handling Diagnostic Radioisotopes (진단용 방사성동위원소 취급 시 L-block 차폐기구 사용에 따른 핵의학 종사자의 장기 선량평가)

  • Kang, Se-Sik;Cho, Yong-In;Kim, Jung-Hoon
    • Journal of radiological science and technology
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    • v.40 no.1
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    • pp.49-55
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    • 2017
  • In the case of nuclear medicine practitioners in medical institutions, a wide range of exposure dose to individual workers can be found, depending on the type of source, the amount of radioactivity, and the use of shielding devices in handling radioactive isotopes. In this regard, this study evaluated the organ dose on practitioners as well as the dose reduction effect of the L-block shielding device in handling the diagnostic radiation source through the simulation based on the Monte Carlo method. As a result, the distribution of organ dose was found to be higher as the position of the radiation source was closer to the handling position of a practitioner, and the effective dose distribution was different according to the ICRP tissue weight. Furthermore, the dose reduction effect according to the L-block thickness tended to decrease, which showed the exponential distribution, as the shielding thickness increased. The dose reduction effect according to each radiation source showed a low shielding effect in proportion to the emitted gamma ray energy level.

Preoperative Staging of Endometrial Carcinoma by MRI (자기공명영상을 통한 자궁내막암의 수술전 병기 결정)

  • Kim, See-Hyung;Cho, Jae-Ho;Park, Bok-Hwan
    • Journal of Yeungnam Medical Science
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    • v.19 no.2
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    • pp.116-125
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    • 2002
  • Background: In patients with endometrial carcinoma, preoperative evaluation of exact staging has important prognostic and therapeutic implications. The incidence of pelvic and aortic lymph node involvement in endometrial carcinoma depends on grade of tumor differentiation and depth of myometrial invasion. Material and method: To evaluate whether MRI provides a preoperative assessment for staging of endometrial carcinoma, MRI was undertaken in 28 patients, a few weeks before operation. Myometrial invasion was devided in three categories, and involvement of cervix, adnexa, and pelvic cavity were classified. Results: The results of MR imaging were compared with these of pathology. The preoperative MRI staging of endometrial carcinoma was correct in 22 out of 28 patients. In the evaluation of myometrial invasion, the MR imaging underestimated in 4 cases and overestimated in 1 case. Conclusion: In patients with endometrial carcinoma, MR imaging is very useful in the assessment of the depth of myometrial invasion, stromal invasion of cevix, lymphatic & pelvic metastases and extent of the lesion.

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A Study on Production and Its Usefulness of AAPM TG18 Guiding Instrument for Diagnostic Monitor QC (영상의학 검사 판독용 모니터 정도관리 Guiding Instrument 제작과 유용성 고찰)

  • Son, Gi-Gyeong;Sung, Dong-Wook;Jeong, Jae-Ho;Kang, Hui-Doo;Ryu, Kyung-Nam
    • Korean Journal of Digital Imaging in Medicine
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    • v.10 no.1
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    • pp.21-28
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    • 2008
  • Diagnostic display monitor QA according to AAPM TG18 is usually performed by PACS administrator, product manager and reading doctor, and for acceptance testing and periodic quality control evaluation, a combination of visual and quantitative tests can be used, as outlined in sections 5 and 6 of 'assessment of display performance for medical imaging systems'. Although many display tests can be performed visually, a more objective and quantitative evaluation of display performance requires special test tools. The required instruments vary in their complexity and cost, depending on the context of the evaluation(research, acceptance testing, or quality control) and how thorough the evaluation needs to be. Objective and reliable assessment of many display characteristics can be performed with relatively inexpensive equipment, So, we made 'AAPM TG18 guiding instrument' to ues variable purpose of the evaluation of 'geometrical distortions(quantitative"', 'veiling glare(visual)' and 'sensor calibration'. The spatial measurements for the quantitative evaluation of geometric distortions, and the measurement of the veling-glare ring response function which provides information regarding the spatial extent of the luminance spread, can be performed using the TG18 guiding instrument can be used to sensor calibration to standardize the basic rate of 0% luminance when periodic calibration.

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Usefulness of MRI Scoring System for Differential Diagnosis between Xanthogranulomatous Cholecystitis and Wall-Thickening Type Gallbladder Cancer (황색육아종성 담낭염과 벽비후형 담낭암의 감별진단을 위한 자기공명영상 점수체계의 유용성)

  • Soul Han;Young Hwan Lee;Youe Ree Kim;Eun Gyu Soh
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.147-160
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    • 2024
  • Purpose To define an MRI scoring system for differentiating xanthogranulomatous cholecystitis (XGC) from wall-thickening type gallbladder cancer (GBC) and compare the diagnostic performance of the scoring system with the visual assessment of radiologists. Materials and Methods We retrospectively analyzed 23 and 35 patients who underwent abdominal MRI and were pathologically diagnosed with XGC and wall-thickening-type GBC after surgery, respectively. Three radiologists reviewed all MRI findings. We defined a scoring system using these MRI findings for differentiating XGC from wall-thickening type GBC and compared the area under the curve (AUC) of the scoring system with the visual assessment of radiologists. Results Nine MRI findings showed significant differences in differentiating the two diseases: diffuse gallbladder wall thickening (p < 0.001), mucosal uniformity (p = 0.002), intramural T2-high signal intensity (p < 0.001), mucosal retraction (p = 0.016), gallbladder stones (p < 0.001), T1-intermediate to high-signal intensity (p = 0.033), diffusion restriction (p = 0.005), enhancement pattern (p < 0.001), and phase of peak enhancement (p = 0.008). The MRI scoring system showed excellent diagnostic performance with an AUC of 0.972, which was significantly higher than the visual assessment of the reviewers. Conclusion The MRI scoring system showed better diagnostic performance than the visual assessment of radiologists to differentiate XGC from wall-thickening-type GBC.

Material Degradation in KS D 3503 SS400 Rolled Steel at $179^{\circ}C$ (KS D 3503 SS400 압연강 $179^{\circ}C$에서의 재질열화 연구)

  • Baek, Un-Bong;Park, Jong-Seo;Nahm, Seung-Hoon
    • Journal of the Korean Society of Safety
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    • v.21 no.4 s.76
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    • pp.13-18
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    • 2006
  • In spite of frequent defect in industrial boilers, life assessment or diagnostic method for them has not been actively studied. In this research, SS400 carbon steel used in industrial boilers is simulated with artificial aging heat treatment. To do qualitative life assessment, differences in micro-structures and hardness of SS400 by the degradation time are studied. In addition, variation in material properties by aging was observed with the tensile test at room temperature and $179^{\circ}C$ and changes in ductile to brittle transition temperature was observed with the charpy impact test performed at several test temperature.

Current and Future Challenges of Student Assessment in Medical Education from an Outcome-based Education Perspective (성과중심교육 측면에서 우리나라 의과대학 학생평가의 현실과 과제)

  • Park, Jang Hee
    • Korean Medical Education Review
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    • v.15 no.3
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    • pp.112-119
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    • 2013
  • Most medical colleges in Korea have been shifting from traditional education to outcome-based education, which is the general trend in medical education. The purpose of this study was to make some suggestions in light of the reality and challenges of student assessment in medical education from the perspective of outcome- based education. First, those who are responsible for student assessment should be diversified to include faculty, residents, students, and evaluation committee members. They need separate roles in educational evaluation, so evaluation competencies are required for them. Second, various methods for evaluation and score interpretation can be used for effective evaluation. We can adopt diagnostic, formative, and summative evaluation functionally, and the norm-referenced, criterion-referenced, growth-referenced, and ability-referenced evaluation based on criteria for score interpretation. Finally, various evaluation domains and test forms can be administered together in the common lectures in the medical school. We can test not only knowledge but also skills and attitudes, with diverse test forms such as supply and performance types.

A Systematic Review of Child Abuse Screening Instruments (아동학대 평가도구의 체계적 고찰)

  • Kim, Hyun-Kyoung;Choi, Hye-mi;Park, Hyun-Jung
    • Child Health Nursing Research
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    • v.22 no.4
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    • pp.265-278
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    • 2016
  • Purpose: The aim of this study was to conduct a systematic review and to describe the characteristics of child abuse screening instruments. Methods: Articles regarding the development of a child abuse screening instrument were investigated using the systematic review method. A literature search using the keywords "child and abuse or maltreatment and instrument or screening tool" in English, and "child," "abuse," and "instrument" in Korean, was conducted of material published in PubMed, PsycINFO, CINAHL, SCOPUS, ERIC, and RISS. Database and bibliographic searches, and quality appraisal using the Quality Assessment of Diagnostic Accuracy Studies tool that included systemic reviews, yielded 17 records. Results: Key elementary child abuse screening instruments were developed for physical, psychiatric, affective and sexual and child neglect assessment. The instruments' target populations were children at home and in institutions. The reviewed instruments had the advantage of diagnosing past, concurrent, and indirectly, potential child abuse. Conclusion: The results of this study demonstrate that child abuse screening instruments are available for screening and for assessment of abused children in various circumstances. This review of child abuse screening instruments offers evidence for the acceptable use of optimal psychometric tools for child abuse assessment and provides guidelines for child health nursing practice.

Identification of Molecular Markers for Population Diagnosis of Korean Fir (Abies koreana) Vulnerable to Climate Change

  • Kim, Dong Wook;Park, Da Young;Jeong, Dae Young;Park, Hyeong Cheol
    • Proceedings of the National Institute of Ecology of the Republic of Korea
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    • v.1 no.1
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    • pp.68-73
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    • 2020
  • Korean fir (Abies koreana) is an evergreen coniferous tree species that is unique to South Korea. A. koreana is found in a limited sub-alpine habitat and is considered particularly vulnerable to climate change. Identification of populations vulnerable to climate change is an important component of conservation programs. In this study, a heat stress-induced transcriptome RNA-seq dataset was used to identify a subset of six genes for assessment as candidate marker genes for ecologically vulnerable populations. Samples of A. koreana were isolated from ecologically stable and vulnerable regions of the Halla and Jiri mountains, and the expression levels of the six candidate markers were assessed using quantitative real-time polymerase chain reaction. All six of the candidate genes exhibited higher expression levels in samples from vulnerable regions compared with stable regions. These results confirm that the six high temperature-induced genes can be used as diagnostic markers for the identification of populations of A. koreana that are experiencing stress due to the effects of climate change.